Different authors have modelled myofascial tissue connectivity over a distance using cadaveric models, but in vivo models are scarce. The aim of this study was to evaluate the relationship between pelvic motion and deep fascia displacement in the medial gastrocnemius (MG). Deep fascia displacement of the MG was evaluated through automatic tracking with an ultrasound. Angular variation of the pelvis was determined by 2D kinematic analysis. The average maximum fascia displacement and pelvic motion were 1.501 ± 0.78 mm and 6.55 ± 2.47 °, respectively. The result of a simple linear regression between fascia displacement and pelvic motion for three task executions by 17 individuals was r = 0.791 (P < 0.001). Moreover, hamstring flexibility was related to a lower anterior tilt of the pelvis (r = 0.544, P < 0.024) and a lower deep fascia displacement of the MG (r = 0.449, P < 0.042). These results support the concept of myofascial tissue connectivity over a distance in an in vivo model, reinforce the functional concept of force transmission through synergistic muscle groups, and grant new perspectives for the role of fasciae in restricting movement in remote zones.

Clear cell renal cell carcinoma (ccRCC) is the most common subtype of kidney cancer. While the localized form of this disease can be treated surgically, advanced and metastatic stages are resistant to chemotherapies. Although more innovative treatments, such as targeted or immune-based therapies, exist, the need for new therapeutic options remains. ccRCC presents unique metabolic signatures and multiple studies have reported a significant increase in levels of reduced glutathione (GSH) and its precursors in ccRCC tumor samples compared with normal kidney tissues. These observations led us to investigate the effects of blocking the GSH pathway, particularly the gamma-glutamyltransferase 1 (GGT1) enzyme, in multiple ccRCC cell lines. In this study, we provide in vitro and in vivo evidence that GGT1/GSH pathway inhibition impacts ccRCC cell growth, through increased cell-cycle arrest. Of note, GGT1 inhibition also impairs ccRCC cell migration. Finally, pharmacologic GSH pathway inhibition decreases ccRCC cell proliferation and increases sensitivity to standard chemotherapy. Our results suggest that GGT1/GSH pathway inhibition represents a new strategy to overcome ccRCC chemoresistance. Implications: GGT1/GSH pathway inhibition represents a promising therapeutic strategy to overcome chemoresistance and inhibit progression of ccRCC tumors.

Resumen.-OBJETIVO: Los objetivos fundamentales de éste trabajo son dos. Por una parte exponer la técnica empleada en nuestro Servicio ya que difiere en algunos aspectos importantes de las publicadas en otros centros, explicando en algunos casos pequeños detalles que pueden ayudar al mejor desarrollo de la técnica. Por otra parte, exponemos los resultados de una serie de 100 casos. MÉTODOS: Presentamos nuestra serie reciente de URS Flex para el tratamiento de la litiasis renal. Para ello hemos revisado de forma retrospectiva éste tratamiento desde Enero de 2007 hasta Marzo de 2010. El tamaño medio de la litiasis tratada es de 1.5cm (0.5-6cms) y en todos los casos utilizamos vainas protectoras del ureteroscopio. La litotricia empleada en todos los casos fue láser de holmio con fibras de 200 y 365 micras RESULTADOS: El porcentaje de pacientes que quedaron libres de litiasis (stone free rate-SFR) tras la cirugía en el postoperatorio inmediato fue de 77/100 pacientes (77%) contabilizando como resto litiásico fragmentos visualizados mediante la fluoroscopia del quirófano y la visión directa del URS Flex. A los 3 meses de la cirugía 89/96 pacientes (92.7%) estaban libres de litiasis comprobado mediante urografía intravenosa. Respecto a las complicaciones destacar 5 pacientes con lesión ureteral durante la colocación de la vaina protectora y 9 pacientes que acudieron a urgencias en el postoperatorio por molestias secundarias al catéter doble J. CONCLUSIÓN: Como conclusión podemos defender el tratamiento de las litiasis renales mediante URS Flex hasta un tamaño máximo de 2 cm siguiendo nuestro algoritmo terapéutico.

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